Case Manager RN

Case Manager RN

  • MM slash DD slash YYYY
  • Self-Assessment Rating Scale:

    No Experience
    Theory or observation only during the past 12 months

    Limited Experience
    Performed less than 12 times within the past 12 months and may need a review

    Performed at least once per month within the past 12 months and may need minimal assistance

    Highly Skilled
    Performed on at least a weekly basis over the past 12 months; proficient
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Toddler (1-3 yrs)
    Preschool (3-5 yrs)
    School Age Child (5-12 yrs)
    Adolescents (12-18 yrs)
    Young Adults (18-39 yrs)
    Middle Adults (39-64 yrs)
    Older Adults (64+ yrs)
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Call center
    Home health
    Insurance company
    Long term care
    Occupational health
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Assessment - Continued stay reviews
    Assessment - Cost management
    Assessment - Diagnosis
    Assessment - Prior authorization
    Assessment - Prognosis
    Assessment - Resource utilization
    Assessment - Treatment course
    Assessment - Treatment options
    Guidelines - InterQual criteria
    Guidelines - Medicare
    Guidelines - Milliman
    Perform - Benefits eligibility review
    Perform - Computerized charting
    Perform - Concurrent utilization review
    Perform - Drug utilization review
    Perform - Patient and family teaching
    Perform - Precertification review
    Perform - Retrospective utilization review
    Planning - Collaboration with family
    Planning - Collaboration with healthcare team
    Planning - Develop appropriate case management strategy
    Planning - Discharge planning
    Planning - Identify short term and long term goals
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Understand TJC national patient safety goals
    Understand TJC prohibited abbreviations
    Universal precautions

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